Smoking marijuana isn't the biggest concern for your doctor, unless perhaps he or she is a Republican

Marijuana use is not among your doctor's major worries, but that might depend on his or her politics, according to a study published in the Proceedings of the National Academy of Sciences. Yale University researchers Eitan Hersh and Matthew Goldenberg "presented a representative sample of 233 primary-care physicians with nine hypothetical patient behaviors -- tobacco use, alcohol use, obesity, etc. -- and asked them how much of a problem they thought these behaviors were on a 10-point scale," Christopher Ingraham writes for The Washington Post.

Abortions and marijuana use were tied as the "least-worrisome behaviors," while alcohol use, tobacco use, obesity and depression were rated significantly more problematic. (In 2012-14, 32 percent of adults in Kentucky were obese, 27 percent smoked, and they averaged five mentally unhealthy days per month.) "By contrast, doctors rated not wearing a helmet while riding a motorcycle and having intercourse with sex workers several times a year as the most problematic behaviors on the list," Ingraham writes.

Washington Post chart

Though the findings "add some empirical heft" to a Scientific American essay by Nathaniel Morri, the original intent of the study was to find a political distinction between Republican and Democratic doctors' opinion on marijuana use. "Republican doctors were, on average, much more concerned about marijuana use than their Democratic colleagues," Ingraham writes. His colleague Erin Blakemore reported, "When faced with hypothetical scenarios involving politically charged issues, they make different treatment decisions."

Republican doctors are also more likely to discuss both health and legal risks of marijuana to "urge the patient to cut down," according to the study. Ingraham added: "The doctors were also polarized over the relative seriousness of previous abortions (Republican doctors more concerned) and of the presence of guns in the home (Democratic doctors more concerned)."

Researchers are more concerned with heavy use of marijuana -- the people who use marijuana daily, or multiple times a day, Ingraham writes. "Those people are at a greatest risk for dependency and various health problems associated with heavy use -- even if those problems don't appear to be as severe as the debilitating conditions associated with long-term heavy tobacco or alcohol use."

Kentucky Hospital Association will be part of a national effort to reduce infections, other acquired conditions, and readmissions

The Kentucky Hospital Association says it will again be part of a national effort to reduce preventable hospital-acquired conditions and readmissions.

“Kentucky hospitals work very hard to provide the highest quality and safest care possible. We are constantly adopting new evidence-based practices to improve our patient outcomes," KHA President Michael T. Rust said in a news release. "Quality improvement is never finished, and we proudly pledge to continue finding ways to sustain the patient safety gains we’ve made, while improving overall quality and safety across Kentucky.”

KHA will participate as part of the American Hospital Association's role in one of 16 "Hospital Improvement Innovation Networks," which will work through 2019 to achieve a 20 percent reduction in overall patient harm and a 12 percent reduction in hospital readmissions within 30 days of discharge. They will also work to assure health equity for Medicare patients, the release says. All efforts will be monitored by the Centers for Medicare and Medicaid Services.

Some areas of patient harm to be addressed include adverse drug events, infections related to central lines, surgical sites and catheters, antibiotic stewardship programs, sepsis, pressure ulcers and injuries from falls.

The release says KHA will build on its ongoing Hospital Engagement Network efforts, which has provided leadership and support for 77 Kentucky hospitals as they reduced preventable readmissions and hospital-acquired infections and other conditions over the past four years.

Millions of Americans miss out on tax credits for health insurance because they don't buy policies on government exchanges

Commonwealth Fund graphic:
People who visited marketplaces, but didn't enroll

About 2.5 million Americans are overpaying for health insurance because they don't use the government exchanges or marketplaces that provide tax credits to reduce premiums, says a study by the Department of Health and Human Services. Kentuckians will use the federal exchange to enroll, starting Nov. 1.

HHS estimates that of the 6.9 million people who have health insurance in the off-exchange individual market, "1.9 million either have incomes that would qualify them for Medicaid or place them in the Medicaid coverage gap, or are ineligible to purchase marketplace coverage due to immigration status, while the remainder could enroll in marketplace-qualified health plans."

Amother problem is that only 46 percent of uninsured adults (as of spring 2015) were aware that the Patient Protection and Affordable Care Act offers financial assistance, according to a 2015 study by The Commonwealth Fund, report the fund's Sophie Beutel, Sara R. Collins and Munira Z. Gunja. Researchers also found that in 2014 more than half of people who visited the marketplace but did not enroll said they weren’t able to find an affordable plan, even though "most of these people had incomes that made them eligible for premium subsidies."

Kentuckians who work for small employers in the state aren't likely to be offered health insurance; most large employers do

Most of Kentucky's small employers don't offer health insurance, while almost all of the state's larger employers do, according to the Foundation for a Healthy Kentucky.

Percentage of Kentucky private-sector employers offering coverage, 2012-15

In 2015, 98.3 percent of Kentucky businesses with 50 or more employees offered health insurance, which was about the same as 2012. But only 26.6 percent of small businesses (fewer than 50 employees) did, dropping from 36.4 percent in 2012.

Private employers of all sizes in the state saw a 6.6 percentage point drop between 2012 and 2015, from 54.4 percent to 47.8 percent, which was largely driven by the decline in small employer coverage.

This reflects a long-term decline in employers offering health insurance, says the report.

"That drop of nearly 10 percentage points means that thousands fewer Kentucky small businesses offered health insurance to their workers in 2015," Ben Chandler, president and CEO of the foundation said in a news release. "We have to make health insurance and health care affordable for all -- residents, workers, employers."

The report says having health insurance is "associated with increased access to needed medical care, better health outcomes and improved health status."

These findings are part of an ongoing, three-year report for the foundation by the State Health Access Data Assistance Center at the University of Minnesota to study the impact of the Patient Protection and Affordable Care Act in Kentucky. The foundation is paying SHADAC more than $280,000 for the work.

Average Premium per Private Sector Employee in Dollars,
Kentucky, 2012-2015, graph from report

The report also found that insurance premiums are increasing for single people, with employers' average annual insurance premium for single private-sector employees increasing $587 from 2012 to 2015, from $5,397 to $5,984. This also reflects a long-term nationwide trend, says the release.

Employer premiums for family coverage did not increase significantly, rising to $16,622 in 2015 from $15,734 in 2012 -- a difference of $888.

This semi-annual report also analyzed data from several sources regarding health coverage, access to care, cost of care, quality of care and health outcomes and included the results of a spring 2016 Kentucky Health Reform Survey of non-elderly adults. Click here for a copy of the report.

Feds allow Bevin to dismantle Kynect and use federal exchange, but express concerns echoed by health-reform advocates

It's official. Kentuckians will sign up for health insurance on HealthCare.gov instead of Kynect during this year's open enrollment, which begins Nov. 1. But there are questions about how smooth the transition will be.

Centers for Medicare and Medicaid Services Acting Director Andrew Slavitt said in a letter dated Oct. 4 to Gov. Matt Bevin that Kentucky had met all of the necessary requirements to make the transition and granted its approval to make the change.

"This transition will allow Kentucky to achieve substantial cost savings while still allowing citizens to enroll in qualified health plans," Amanda Stamper, press secretary for Gov. Matt Bevin's administration, asserted in an e-mail.

Kynect was created with a federal grant and funded by a 1 percent tax on all insurance policies sold in the state, both on and off the exchange.This revenue had previously funded Kentucky Access, the high-risk insurance pool that federal health reform made unnecessary.

The 1 percent tax will continue, and be used to help pay for transition costs, fund the Kentucky Health Information Exchange and "legacy costs" of Kentucky Access, the Bevin administration told a legislative committee in March.

Bevin has said it is unfair for all insurance customers to pay for an exchange that fewer than 100,000 people use. He does not include the 425,000 Kentuckians who used Kynect to sign up for Medicaid year-round.

The fee for using the federal exchange will be 1.5 percent, plus a proposed 0.5 percent state fee to cover outreach and plan-management functions.

Despite CMS's approval, the bulk of Slavitt's letter expressed concerns about the change.

"We remain concerned that Kynect's transition to the federal platform may disrupt the seamless system of coverage that Kynect established. As a result, eligible people may face delays in or lack access to the coverage for which they are eligible," Slavitt wrote.

Slavitt called Kentucky's transition timeline "aggressive" and said "key milestones" remain. He added that such a major transition creates "significant risks."

The approval comes less than one month before open enrollment will begin on Nov. 1. (It ends Jan. 31, but to get coverage starting Jan. 1 enrollees must sign up by Dec. 15.) Stamper told Lisa Gillespie of WFPL that the state will be able to make the switch in time.

“We’ve also been working with [the Centers for Medicare and Medicaid Services] and stakeholders to develop a comprehensive outreach plan to ensure people have the information they need well before open enrollment to know when and how to enroll,” Stamper told Gillespie.

But Cara Stewart, a health-law fellow at the Kentucky Equal Justice Center, said there isn't enough time to make the transition before Nov. 1. One reason, she said, is Kentucky hasn't conducted the same level of outreach that it has in years past because Kynectors who help people navigate the system didn't know what to tell people until today. She also noted that Kynectors must go through training to assist people on the federal exchange.

"And yet this is a change as big as the change the very first year of Medicaid expansion," said Stewart, who is also a Kynector. "And so we are looking at a tremendous amount of information that is not being pushed out there. And on HealthCare.gov, every single person has to create a new account and start from complete scratch, and this system is more cumbersome and more difficult to use than Kynect."

Stewart noted that assisters on the federal exchange are limited in how much they can help their clients because the system doesn't offer a shared dashboard, and without that dashboard they can't help help their clients fill out their applications or check on the application's status.

"We are choosing to set ourselves up for failure," she said. "I don't see any way that we won't have access issues."

Slavitt also noted that on the federal exchange many Kentuckians will have to manipulate two systems instead of just one, as they do now on Kynect, to maintain their health insurance.

Slavitt emphasized the importance of making sure Kentuckians are informed about these changes.

"Changes in system functionality may result in confusion for Kentucky consumers," he wrote. "It is therefore essential that the transition be clearly and effectively communicated to Kentucky consumers to ensure that they have the information they need to enroll in coverage on HealthCare.gov starting Nov. 1, 2016."

Save Kentucky Healthcare, a non-profit founded by former Gov. Steve Beshear, who created Kynect, noted the warnings in Slavitt's letter, including "the high risk of user delays, gaps in coverage, and anticipated confusion as Kentuckians attempt to adjust to a more complicated system." It also asserted that "study after study has found the current system sustainable and affordable."

"It is disappointing that Gov. Bevin is once again putting his rigid right wing ideology ahead of the health and well-being of Kentuckians," Beshear's group said in a press release.

Baptist Health Plan will no longer sell individual health plans in Kentucky; about 7,000 people will be affected

Baptist Health Plan is withdrawing from the individual health insurance market in Kentucky for 2017, according to a state Department of Insurance news release.

Baptist is the state's fourth largest health-insurance provider and serves around 7,000 Kentuckians. It had planned to offer plans in 20 counties on the government exchange and 38 counties off the exchange.

The withdrawal means 59 of the state's 120 counties will have only one health insurance option on the exchange, where tax subsidies are available to reduce premiums. Most Kentucky counties will have two options off the exchange.

The state news release said James S. Fritz, president of Baptist Health Plan, indicated in a letter to state Insurance Commissioner Brian Maynard that "Baptist enrolled more members in the individual market than anticipated in 2016, but "the federal risk assessments placed upon the organization under the Affordable Care Act is unsustainable by a corporation the size of Baptist Health Plan."

The decision by Baptist comes just one month after Aetna announced that it will pull out of the state exchange in 2017, citing financial reasons. Its withdrawal will affect 10 counties in three major metropolitan areas.

Policyholders in Baptist plans can continue coverage through Dec. 31 if they are on the exchange and through March 31 if they are off the exchange. Baptist will notify them of its withdrawal.

Kentuckians signing up for health insurance through the exchange will enroll on Healthcare.gov this year, instead of Kynect, the state's health insurance exchange. Open enrollment begins Nov. 1 and goes through Jan. 31.

Anthem Blue Cross touts its program to help curb opioid abuse, limiting high-risk members to one pharmacy

The opioid epidemic seems to be focused on heroin, but that's only part of the picture, Anthem Blue Cross and Blue Shield President Deb Moessner writes in an op-ed for The Courier-Journal. "Prescription drug abuse and misuse is the other part." At least half of all opioid overdose deaths involve a prescription opioid.

"In Kentucky, deaths from drug overdose went up 4.2 percent between 2013 and 2014, according to the National Vital Statistics System . . . with 24.7 deaths per 100,000 people, Kentucky has the fourth highest death rate nationally of drug overdose deaths in 2014," Moessner writes.

The numbers show "Prescription drug abuse is not just a personal problem, it is a public health problem," Moessner writes, saying everyone from individuals and businesses to governments and community organizations should do their part to turn things around.

Health insurers are in a unique position because they have access to medical records that many doctors and pharmacists do not, so they can bring new tools to the fight to "help curb drug dependence and addiction," Moessner writes.

In April, Anthem launched the Pharmacy Home program "designed to help reduce addiction to opioids and other prescription drugs" by enrolling "high-risk members in a 'pharmacy home,' which limits their drug coverage to one member-chosen home pharmacy," Moessner writes.

"The program will help redirect members to appropriate care, prevent death, and hopefully, prevent deaths and major medical problems from overdose and drug interaction. Neither Anthem's Pharmacy Home program nor proper disposal of prescription drugs will solve the issue of opioid addiction, but they are good first steps." (Read more)

Bevin administration says syringe exchanges funded by state grants must be one-for-one after initial supply to a user

By Melissa Patrick
Kentucky Health News

image: lexingtonhealthdepartment.org

The administration of Republican Gov. Matt Bevin is requiring syringe exchanges funded by state grants to be limited to one-for-one trading of clean needles for dirty ones, raising the chance that all such programs might have to do likewise.

Republicans said in the last legislative session that the 2015 law allowing syringe exchanges was intended to only allow a one-to-one trades. Their effort to impose such a limit died in the House, notes The Floyd County Times in Prestonsburg. The county recently approved an exchange.

If the Democratic-majority House goes Republican in November, both the legislature and the administration would be Republican, and in a position to impose a one-syringe limit. That would reduce the protection provided by syringe exchanges, say health officials running them.

The exchanges are meant to slow the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. They are not required to have a one-for-one exchange because of an opinion by then-Attorney General Jack Conway.

Clark County Health Director Scott Lockard said in a telephone interview that most Kentucky syringe-exchange programs use a "patient negotiation model," which provides the user with as many needles as they need for one week to assure they use a clean needle each time, often up to a capped amount.

"The goal is that they use a clean needle for each time they inject," he said. "We want to stop the spread of HIV. We want to stop the spread of hepatitis C and any of these other blood-borne pathogens that can be spread through the sharing of contaminated needles."

Lockard noted that while a one-for-one exchange is the goal, sometimes it is impossible to adhere to such strict requirements. For example, he said users don't always keep up with their syringes or sometimes will tell you they are sharing them.

So, with a strict one-for-one exchange you aren't able to provide them with enough needles to prevent sharing, "which means you are not doing anything to prevent the spread of disease. And the purpose of these exchanges is to prevent disease," he said.

Dr. Sarah Moyer, then interim director of the Louisville Metro Department of Public Health and Wellness, told Kentucky Health News in March that it is widely accepted that not requiring one-for-one is considered a best practice.

The state grant program requires applicants who plan to use the money for a syringe exchange program to promise that it would be a strict one-for-one exchange after an initial transaction with a client.

Asked why the requirement was added, Van Ingram, executive director of the state Office of Drug Control Policy, said only, "That was an administration decision." The governor's office and the Cabinet for Health and Family Services did not respond to requests for an explanation. Neither did Thayer.

The grant program is funded by the Agency for Substance Abuse Policy. The deadline for application was Sept. 23 and grant amounts will be considered up to $20,000. The grants can also be used for Narcan (naloxone) programs, community education and other harm-reduction efforts. The agency received 38 applications and expects to announce the recipients near the end of October, Ingram's office said.

Boyle and Floyd counties are the most recent counties to approve syringe exchange programs, bringing the total in the state to 20.

Both counties will offer a one-for-one exchanges and have applied for an ASAP grant to help fund their programs. Both say their decision to implement a one-for-one exchange was largely driven by the requirements of the grant.

Boyle County Health Director Brent Blevins said, "The grant we are applying for is very important to help us get this off the ground."

Floyd County Health Director Thursa Sloan said, "It was just a better fit for our area, for the board and for the people. We don't know that that couldn't change down the road, but the funding we are seeking to help support it is contingent on an equal exchange program."

Both Blevins and Sloan noted that the original version of the 2015 legislation called for one-to-one exchanges. Boyle and Floyd, respectively, are considered the 35th and 10th most vulnerable counties in the nation for HIV and hepatitis C outbreaks among those who inject drugs, according to estimates by the federal Centers for Disease Control and Prevention.

Lockard said syringe exchanges are a "very political issue," and while one-for-one exchanges are not the ideal solution, they may be what is "politically palatable."

Ingram stressed the importance of such programs: "We have the fastest growing rate of hepatitis C in the country in large part due to the sharing of needles." He added, "More than 100 people have been guided into treatment as a result of their participation in a needle exchange program.

Baptist Health Corbin and Mountain Comprehensive Health, Whitesburg, get USDA grants to treat addiction via telemedicine

By Melissa Patrick
Kentucky Health News

The U.S. Department of Agriculture has awarded a $720,000 grant to Baptist Health Foundation Corbin Inc. and Mountain Comprehensive Health Corp. in Whitesburg for telemedicine programs that focus on mental health and addiction treatment.

These grants are part of the $1.4 million that the USDA announced in June for five Appalachian projects in Virginia, Tennessee and Kentucky to fight opioid abuse in the high-poverty "StrikeForce" areas and southeastern Kentucky's "Promise Zone," both Obama administration initiatives that steer federal money to areas with persistent economic hardships.

Baptist Health Corbin was awarded $377,121 to help connect clinical specialists through telemedicine to 10 school-based health centers, two primary-care sites in Williamsburg and Barbourville, and Grace Community Health Center.

“Partnering with Grace Community Health Center, telemedicine will offer a unique opportunity to maximize resources and reach isolated communities with healthcare services that are not otherwise available,” Baptist Health Corbin President Larry Gray said in a news release. "While this project cannot address the economic barrier of poverty directly, a telemedicine program can ease the financial burden of accessing care.”

Baptist Health Corbin has one of the largest behavioral health facilities in Eastern Kentucky, The Briscoe Clinic, which provides services to about 750 people a month and has a 200-person waiting list, according to Chris Holcomb, executive director of behavioral health at Baptist Health Corbin. Holcomb said the hospital has enough providers, but not enough office space.

"By utilizing telemedicine technology, we can meet the needs of more people and reduce the waiting list without the financial burden of expanding space," he said, adding that the technology will also decrease transportation barriers for their patients as many of them travel over one hour to the clinic to receive services.

Baptist Health Corbin expects to start providing behavioral health and addiction services through telemedicine in the summer of 2017.

"Our telemedicine launch will not only treat the opioid epidemic, but will have a generalist approach treating a wide array of behavioral health issues," Holcomb said. "We plan to individualize care plans and provide medication assisted treatment for those suffering from addiction. We will also provide assessments for medical detoxification and possibly offer intensive outpatient groups for those with chemical dependency issues."

The telemedicine program at the 10 school clinics will offer continuing education and training for teachers around suicide prevention and drug awareness and will also provide acute behavioral health and addiction screening and assessment for the students.

"By providing in-school assessments, it should help to reduce academic absences and reduce ED visits," he said.

Mountain Comprehensive Health Corp. was awarded $343,600 for its program to expand its telemedicine services to residents who face economic and transportation challenges.

MCHC will initially only offer primary-care services through its telemedicine program, but will expand its services to include behavioral health and addiction services after it has finished building its behavioral-health program, Chris Bates, corporate compliance officer and grant writer for MCHC, said in a telephone interview.

Bates couldn't promise when the telemedicine program would start offering behavioral health and addicition services, but said he expected it would be within one to two years.

MCHC has only one behavioral-health provider, but will add one more next month, and is looking to add four more. Bates noted that this staff is funded through a grant from the federal Health Resources and Services Administration. 

MCHC will initially offer telemedicine in its 13 school-based clinics and eventually will expand the program to its eight facilities. Bates noted that some of their most rural patients travel hours to the clinics for care and having access to telemedicine will help assure they have access to all of the services they need.

"The demand for behavioral health is unreal," he said. "And the relationship between mental health and physical health is intertwined, so we need the ability to address both," Bates said.

Study finds that anti-smoking ordinances help social smokers stop smoking and discourage young people from starting

www,drugfree.org

By Melissa Patrick

Kentucky Health News

Young people who live in areas with smoking bans are less likely to ever smoke, and young males who are light smokers who live in these areas are more likely to give it up altogether if a ban is imposed, according to a new study.

“We found that the implementation of a smoking ban reduces the odds that a young person in that location will smoke at all over time. In other words, young people are less likely to smoke once a smoking ban goes into effect,”Mike Vuolo, co-author of the study and assistant professor of sociology at Ohio State University, said in the news release.

Kentucky's teen smoking rate is 17 percent and its adult smoking rate is 26 percent. About one-third of the state and 35 percent of the state's school districts are covered by comprehensive smoke-free laws.

The study found that young males who were light smokers before a smoking ban was instituted were more likely to stop smoking cigarettes after a ban went into effect. Their probability of smoking dropped to 13 percent in areas with a ban from 19 percent in areas without a ban.

“There’s a lot of evidence that casual, social smokers are influenced by their environment,” Vuolo said. “If they can’t smoke inside with their friends at a restaurant or bar, they may choose not to smoke at all.”

However, smoking bans did not seem to discourage tobacco use among women, whose probability of smoking remained the same, 11 percent, in areas both with or without a ban. The researchers were unable to explain this result, but noted that the women in the study already smoked less than the men.

Regardless of gender, the study found that areas with long-standing smoking bans prevented light smokers from becoming heavy smokers, Vuolo said.

The study also found that smokers who lived in areas without bans were not likely to stop smoking and that smoking bans didn't work to reduce or end smoking for those who smoked more than a pack a day when the bans began.

“This study isolates the effects of smoking bans alongside multiple types of tobacco policy,” Brian Kelly, co-author of the study and director of Purdue's Center for Research on Young People's Health, said. “Ultimately, it identifies smoking bans as the most highly effective policy tool for lawmakers who wish to reduce smoking among young people.”

The study, published in the Journal of Health and Social Behavior, included data from the National Longitudinal Survey of Youth 1997 and the Americans for Nonsmokers' Rights Foundation. It was funded by the National Institute on Drug Abuse.

Passport Health Plan named Kentucky's top Medicaid plan by National Committee for Quality Assurance; others rate lower

Passport Health Plan has again been named the top Medicaid plan in Kentucky, getting a 4 rating on the 5-point scale of the National Committee for Quality Assurance.

The NCQA annually rates more than 1,000 private, Medicaid and Medicare plans across the United States on consumer satisfaction, prevention and treatment measures.

“By focusing on member satisfaction, preventive services, and how we treat chronic and acute conditions, NCQA has once again reinforced what we have known to be true for a long time – Passport Health Plan is a leading model of collaboration and innovation in health care,” Passport CEO Mark B. Carter said in a news release.

The NCQA ratings for other Kentucky Medicaid plans were: WellCare, 3.5 out of 5; Aetna Better Health, 3; Humana, 2.5; and Anthem Blue Cross and Blue Shield, 2.

A list of Kentucky's NCQA ratings, broken down by consumer satisfaction, prevention and treatment, is at http://healthinsuranceratings.ncqa.org/2016/search/Medicaid/KY.

Lexington will host two health conferences in November: one on immunization, one on health-care associated infections

Lexington will host two health conferences in November, one focusing on immunizations and the other on health-care transparency and patient advocacy.

The 2016 Kentucky Immunization Conference, titled "Educate, Immunize, Protect: Kentucky's Immunization Trifecta," will be held Nov. 2-4 at the Embassy Suites in Lexington.

This conference will feature nationally known speakers who will discuss all areas of immunization from infants to adolescents to adults.

A keynote speaker for this event is Dr. Ari Brown, a pediatrician, childcare advocate and author of the bestselling "411" parenting books. Brown also serves as a medical advisor for Parents magazine and a spokeswoman for the American Academy of Pediatrics.

Another keynoter, Rayna DuBose, is a meningitis survivor who will share her story about overcoming adversity and talk about the importance of vaccination.

This conference is sponsored by the Kentucky Rural Health Association in collaboration with the Kentucky Immunization Program. The cost is $100 through Oct. 15, when it will increase to $150. Continuing education credits will be offered. Click here to register.

Health Watch USA Conference

The annual Health Watch USA Conference for Healthcare Transparency and Patient Advocacy will be held Nov. 4 at the Four Points Sheraton in Lexington. This year's conference is titled, "Full Disclosure and Healthcare Associated Infections."

This conference will focus on the impact and magnitude of adverse events in health care, the importance of creating cultures of safety, patient advocacy, medical device patient safety issues and healthcare associated infections.

Keynote speakers include Dr. Jim Bailey, a fellow in the American College of Physicians and professor of medicine and preventive medicine at the University of Tennessee Health Science Center in Memphis; Dr. Lars Aanning, a medical/surgical consultant; and Dr. Mark Davis, an operating-room safety consultant specializing in reducing injuries from sharps and exposure to blood.

The conference is paid for in part by a grant from the Foundation for a Healthy Kentucky. Click here or call 606-425-7278 to register. The cost to attend is $48. Continuing educations credits are offered.